Wastewater could provide up to a week of warning for a COVID-19 spike

Monitoring sewage for
the coronavirus’s genetic material could give public health experts up to a week of warning before
COVID-19 cases peak in an area, a new study finds.

Scientists have found
the coronavirus’s RNA in stool from some COVID-19 patients. Though it remains unclear
whether the virus can be transmitted through feces, researchers have also
detected coronavirus RNA in raw wastewater. Because most people don’t get tested for the virus until
they begin to get sick
, and some may never
develop symptoms (SN: 4/15/20),
researchers are considering using sewage to look for early signs that the virus
has hit a community.

In Connecticut, the
amount of the virus’s genetic material in sewage peaked
a week before the number of cases in one region did
, researchers report in a preliminary study posted May 22 at
medRxiv.org. Hospitalizations related to COVID-19 hit their highest point three
days after RNA levels did.

From March 19 to May 1,
researchers collected sludge — which contains solids that can settle out of
water — from a wastewater treatment facility in New Haven. The team tested the
sludge for coronavirus RNA, and then compared the amount of RNA in those daily samples
with the number of new COVID-19 cases and hospital admissions in the region.

The study “shows that we
can monitor wastewater in cities to get an early warning of when coronavirus
outbreaks will occur,” says Aaron Packman, a civil and environmental engineer
at Northwestern University in Evanston, Ill., who was not involved with the
work.

Public health experts already use wastewater to track pathogens
like poliovirus, norovirus and antibiotic-resistant bacteria. Such
surveillance for the coronavirus could help pinpoint areas where cases will
soon be on the rise.

And as states begin to
loosen social distancing guidelines designed to curb the spread of the
coronavirus, samples from wastewater treatment plants, along with widespread diagnostic
testing and contact tracing
, could help experts
flag when to implement local control measures to slow the virus’ spread (SN: 4/29/20).

“It’s far better to get an early warning than waiting until you have large numbers of sick people,” Packman says.

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